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Alwyn - Treatment Analysis
#11
RE: Alwyn - Treatment Analysis
i would stick to EPR2 since it was so effective at getting rid of CAs. yeah of course 7-12 or even 7-10 would also be good to start with.

your minute vent seems fairly close to the normal 5-8L range, not sure if the dips under are significant. minute vent is probably more significant than tidal volume since it represents how much air you're actually getting over a minute. you must be compensating the lower tidal volume by a slightly faster breathing rate. still finding the cause would be nice.
Quote:Normal minute ventilation is between 5 and 8 L per minute (Lpm). Tidal volumes of 500 to 600 mL at 12–14 breaths per minute yield minute ventilations between 6.0 and 8.4 L, for example.

i wouldn't put much trust in chatGPT, other than comical entertainment. it's far from reliable enough to give medical-ish advice. Personally i think it should be banned from this forum.

hopefully an American can give you a reference!

Sleep-well
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#12
RE: Alwyn - Treatment Analysis
(05-23-2024, 08:26 PM)Narcil Wrote: i wouldn't put much trust in chatGPT, other than comical entertainment. it's far from reliable enough to give medical-ish advice. Personally i think it should be banned from this forum.

It basically is.
Rule 12. Use of Artificial Intelligence (AI) to generate content is strictly prohibited anywhere on Apnea Board. The only exception to this rule is when discussing AI technology in the Off Topic Forum, as long as the phrase "Artificial Intelligence" (or simply "AI") is used in the thread title. For disclosure purposes, any AI-generated content in those thread posts must include the notice "START of AI content" immediately before the content and "END of AI content" immediately after it.

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Crimson Nape
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#13
RE: Alwyn - Treatment Analysis
(05-23-2024, 09:14 PM)Crimson Nape Wrote: It basically is.
Rule 12.  Use of Artificial Intelligence (AI) to generate content is strictly prohibited anywhere on Apnea Board.  The only exception to this rule is when discussing AI technology in the Off Topic Forum, as long as the phrase "Artificial Intelligence" (or simply "AI") is used in the thread title.  For disclosure purposes, any AI-generated content in those thread posts must include the notice "START of AI content" immediately before the content and "END of AI content" immediately after it.

- Red

I'll try and remember this.  

It's just a tool, like anything else.  The technology is improving.  The more we use it, the more we'll be able to help it give better answers and the more we'll learn ourselves.

Of course it makes sense for us to critique any information it gives us, and critical analysis skills should be used at all times, but in the end it's only going to be a supportive technology that will benefit all of us.
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#14
RE: Alwyn - Treatment Analysis
(05-23-2024, 09:14 PM)Crimson Nape Wrote: It basically is.
Rule 12.  Use of Artificial Intelligence (AI) to generate content is strictly prohibited anywhere on Apnea Board.  The only exception to this rule is when discussing AI technology in the Off Topic Forum, as long as the phrase "Artificial Intelligence" (or simply "AI") is used in the thread title.  For disclosure purposes, any AI-generated content in those thread posts must include the notice "START of AI content" immediately before the content and "END of AI content" immediately after it.

- Red

good! completely forgot that part..
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#15
RE: Alwyn - Treatment Analysis
Ha ha, as a programmer I have caught ChatGPT out too many times, so I don't just accept what it comes back with.  

Narcil, first on the minute vent.  I do find that it often drops down to 3.  I'll keep an eye out on it.

So last night, I did find that I do sometimes push out air through my mouth (know since awake the whole night).  Still having a hell of a time with those pillows, can't seem to position them right.  Less dry mouth last night though, probably due to increased pressure helping with nasal obstruction??

Overall the stats are a bit worse and felt unrested like the last night, most of the events happened after 4 AM (CA, RERA, H) which I think is about the time where I thought "screw this I'm going to not force myself to be on my side".  I do seem to move around A LOT and the only times my flow rate (at least on the positive part of the graph) is not spikey is when I seem to be able to not move too much.  I did have pain in my right side last night which probably made it difficult to sleep on that side.

Tonight I'm deciding between doing fixed pressure again or doing APAP.  The APAP feels good when influx is below 7, was worried that EPAP might go uncomfortably high.  Reason I am considering fixed is because I'm not sure if the changing pressure agrees with how my chest currently feels.

If I go fixed I might do 8 with EPR 3 since EPAP 5 seems to work for me (might be wrong)

If I stay APAP, I would probably go 6 - 9.  Not sure if I'll stay EPR 2, because then I'll end up with EPAP 7 (40 % of time).

Looking at last night's graph, any insights?


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#16
RE: Alwyn - Treatment Analysis
the machine wants to give you more pressure since it's hitting the max and you're still flow limited.

if you do cpap maybe slowly increase the pressure the machine you can do steps of .2 instead of doing 1cm at a time. you can try epr3 see if the CAs come back, it should also help with the FLs.

if you try apap again i would also slowly raise the pressures to try to deal the FLs. the few H/RE coincide with the leak events, could be false positives or not but either way not a big problem. maybe try 5.6-8.6 ? it doesn't take much sometimes.
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#17
RE: Alwyn - Treatment Analysis
I will give it a shot.

Wish I could do something to improve the leaks, even considering a FFM again and I hated that long time ago due to fighting the tube all the time.

I have this hope that if I can get rid of all leaks and events that wake me up then I'll stop moving around so much in my sleep too and get proper sleep.
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#18
RE: Alwyn - Treatment Analysis
I'm really sorry to hear about your recent accident and health troubles.


Here's my take;

APAP mode, 6.5min to 10.5max (no EPR) - Either way, your pressures are too low, especially min pressure with the added EPR.

use that for a week, then find your median 95th% percentile. Then dial the minimum to your 95th number, then add 2cm to that number for your max pressure setting. Keep an eye on all your stats of course. As long as your CA, OA & H add up to be below 5. The other events recorded on your machine are a little less meaningful, and they're very low, so I wouldn't look at adding them into the calculation as of yet. I've found that FL can be caused by several things, not just from the pressure you set your machine to.

Some people would say to aim for a total number below 2, most of the time, in order to really feel like your therapy is optimal. In saying that, for some people, an AHI of 10 is still reasonable. It really depends on what's going on inside of you. There can be many reasons for fatigue and lethargy, low energy etc.

Try a better mask like the F&P Brevida.

The more you use A.I, the more it learns. IME it has been pretty much on the money, and rarely having hallucinations.


Feel free to PM me anytime.
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#19
RE: Alwyn - Treatment Analysis
Last night was the first time in a long while that I did not feel awake the whole time.  Unfortunately it might be because I took half a dose of Nyquil.  For the non-Americans (which technically includes me) the ingredients are acetominophen, phenylephrine HCL, Dextromethorphan HBr and Doxylamine succinate.

The Nyquil probably helped my mucus generation since I have far less this morning, so probably clearer airways during the night.

Resting heart rate spent about 2 hours around 56 which I find surprising since I'm in bad physical shape. Of course it spikes to 90+ every time I move, which was less often last night.

Stats not too bad.  Any time I'm around 0.5 I'm happy (as long as I feel good too) I think I'll modify in the direction Tom is advising, just gradually reducing EPR to see what the effect is.

Tom, for the Brevida mask, what kind of tubing do I need to connect it to a Climatelineair?


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#20
RE: Alwyn - Treatment Analysis
Your FL are high - flow limits are apnea just like Oa and H events but they don'thave them long enough to bee classified as an Oa or H event.  When the Resmed finds a flow limit the machine raises the min pressure to stop it from getting to an Oa or H event.

I would suggest 

Min 7
EPR full time
EPR 3
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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